From India—International Aortic Summit: There Is Nothing Impossible for Those Who Will Try!

The aorta is a dynamic living structure, central to all vital organs with its aortovascular branches. At the center of the affair, the aorta is af ﬂ ictedwith aneurysm disease, a complex condition that warrants attention and a multidisciplinary huddle to understand and ameliorate its dire effects. The International Aortic Summit in Chennai, India, is not just a conference

The aorta is a dynamic living structure, central to all vital organs with its aortovascular branches. At the center of the affair, the aorta is afflicted with aneurysm disease, a complex condition that warrants attention and a multidisciplinary huddle to understand and ameliorate its dire effects. The International Aortic Summit in Chennai, India, is not just a conference, but a confluence of multidisciplinary specialties and teams joined around a rounded table of innovation and collaboration.
The 9th International Aortic Summit 2020 (IAS2020) was a witness to such confluence and was not hindered by the untoward effects of the pandemic. We streamed live globally bringing esteemed colleagues to deliver an eye and reflective practice on their experiences and expertise. Viewed globally by over 42 countries, IAS2020 was organized into structured sessions and platforms to cover all profiles of aortic disease and surgery.
Aortic surgery practice in India was a major focus during the Summit. Discussants touched the outcome and available resources. The aim was to incentivize practicing surgeons and young aspiring colleagues to form a solid practice and surgical approach structured, devised, and based on clinical evidence and research.
Sessions dedicated to pioneers in aortic surgery were a mere reflection of sheer and driven practices. Those were imperative to impose the way the future is evolving and to incite young surgeons to follow pursuit.
Keynote speakers including Drs Joseph Coselli and Joseph Bavaria delivered their shrewd expert opinions on aortic surgery over their decades of experience; the key points and sessions are listed in ►Tables 1 and 2. There were discussions on a wide range of topics related to thoracic and abdominal aortic aneurysms, aortic dissections, genetics pertaining to the aorta, interventional aortic radiology, and novel endovascular aortovascular innovations. The summit was a relishing opportunity to the current trend of aortic surgery in India and advances made across the years, best told by B.V.V., the Summit Director and propeller of innovation in aortic surgery management in India.
Following on to IAS2020, we developed a strong collaboration with AORTA and reflected on the key topics selected from the core of IAS2020. The selected topics were the crux of the two consecutive days of the summit and formed this focused issue. The articles collated were debates on pertinent topics which remain controversial and require profound attention. Practical sessions highlighted during the summit were invigorated and supported by contributors including innovative surgical approaches that emerged over the past years. The endovascular side of the program was thoroughly covered adding a touchstone and face value to furthering aortic surgery in current and future eras. The thoracoabdominal part was again a station that intrigued the audience during the Summit and after. As such, articles were collated to support this stem and to a prime foundation for future events.
With the success of the 9th IAS, we are promising our readers, subscribers, and followers that the 10th IAS will see through live operating workshops performed by esteemed colleagues' debates to induce guidance and appropriate decision-making, and case-based discussions to highlight surgical perspectivity (►Fig. 1). Cardiac surgical devices and prostheses have undergone multiple innovations and developments in the last few decades.
To work with our colleagues closely-cardiologists, radiologists, and vascular surgeons.
Enumerated the developments in aortic arch surgery over the years.
Prof. Joseph Bavaria, Philadelphia, PA Type A Dissection: From the 30/30 club disaster to an upcoming Innovative decade Most important concept in future is in regard to "distal aorta": Index proximal operations will be driven and conceived by the availability of new technology endografts.
Proximalization of the conduct of aortic arch operations will continue. Index operations "tactics"' will be driven to reduce total cardiopulmonary bypass time.
Achieve better accumulation of outcomes data on the global stage.  • Distal extent preferably hemiarch, unless a total arch replacement is necessary • Total arch replacement is performed when the entry tear is within the greater curvature, severe compression of the true lumen • When stented, a 10-cm antegrade delivery is preferred Dr. Arminder Jassar, United States The changing surgical approaches for Type A dissection • Ascending aortic replacement will suffice for many, but not all, patients with acute Type A dissection • While the goal of the operation is to have an alive patient, it is also reasonable to plan for the future • For patients with acute malperfusion, alternative strategies or adjunct techniques should be considered to ensure reperfusion (Continued)

Day 2
Aortic Surgery in Asia -II: Dr. Bashi Velayudhan, India Acute aortic syndrome (AAS) in India-What do we know?
• Possibility of a lower incidence of the acute aortic syndrome as compared to the western world (due to diabetes mellitus) • Majority of patients are in the younger age group • Last 15 years-more centers to handle AAS • Distal aorta in Marfan's syndrome-still a challenge Dr. Shiv Choudhary, India Inexpensive way to manage the arch in acute Type A dissection   • Spinal cord ischemia prevention requires optimizing all aspects of the procedures • CSF drainage is a valid adjunct; however, it comes with several potential serious complications • The problem is still not resolved, and more research is needed Abbreviations: ARR, aortic root replacement; CSF, cerebrospinal fluid; CTA, computed tomography angiography; dSINE, distal stent graft induced new entry; FET, frozen elephant trunk; FEVAR, fenestrated aneurysm repair; IMH, intramural hematoma; PAU, penetrating atherosclerotic ulcer; TAAD, Type A aortic dissection; TAAAR, thoracoabdominal aortic aneurysm repair; TEVAR, thoracic endovascular aortic repair;